Coronary revascularization strategies in patients with chronic heart failure

Chronic heart failure (CHF) is a worldwide public health problem owing to its high prevalence and incidence (especially in industrialized countries). Although CHF may occur in different physiopathology scenarios, nowadays, atherosclerotic coronary artery disease represents the most common cause of heart failure. Data from observational studies suggest that patients with coronary disease and left ventricular dysfunction may have improved outcomes after both surgical and percutaneous revascularization. However, the selection of which patients might benefit from revascularization, the time of revascularization and the choice of treatment strategy in this subset of patients remains under debate. The aim of this article is to describe the effect revascularization strategy has on outcomes in CHF patients’ and to examine the role of noninvasive viability testing. It also aims to offer an evidence-based perspective that may differ from the current standard of practice.